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Additional resources for ABC of Breast Diseases, 3rd edition (ABC Series)
Radiolabelled occult lesion localisation (ROLL) is an alternative method to wire marking and may be associated with less discomfort. Superficial lesions can also be effectively localised by skin marking. If the procedure is being performed to establish a diagnosis, a representative portion of the lesion is excised through a small incision, so leaving a satisfactory cosmetic result if the lesion proves to be benign (the European surgical quality assurance guidelines require such diagnostic surgical excision specimens to weigh Ͻ 30 g).
Neither atypical ductal hyperplasia nor lobular carcinoma at the margins increases local recurrence and re-excision based on their presence at a resection margin is not necessary. The risk of local recurrence falls with increasing age: young patients (Ͻ35) are two to three times more likely to develop local recurrence than older patients. Although younger women with breast cancer are more likely to have other risk factors for local recurrence, young age is an independent risk factor. Invasive cancers with an extensive in situ component (EIC) were reported to recur more often, but, providing margins are clear, EIC does not increase recurrence rates.
Breast 1999;8:215 (abstract). Dupont WD. Risk factors for breast cancer in women with proliferative breast disease. New Engl J Med 1985;312:146–51. Hackshaw AK, Paul EA. Breast self-examination and death from breast cancer: a meta-analysis. Br J Cancer 2003;88:1047–53. Nystrom L, Andersson I, Bjurstam N, Frisell J, Nordenskjold B, Rutqvist LE. Long-term effects of mammography screening: update overview of the Swedish randomized trials. Lancet 2002;359:909–19. Tabar L, Yen M-F, Vitak B, Chen H-HT, Smith RA, Duffy SW.